Aim
This study was performed to evaluate the existence of biofilm in the endotracheal tube (ETT) of mechanically ventilated children, and to study a microbial link between biofilm flora and bacteria causing ventilator-associated pneumonia (VAP).
Patients and methods
This was a prospective study conducted on 20 children with ETT who were evaluated for biofilm existence using scanning electron microscopy.
Results
A total of 20 children were enrolled in the study. Of them, 17 (85%) children showed biofilm formation on the luminal surface of ETT. A significant relationship was observed between duration of intubation and biofilm stage. Of the 17 positive cases with biofilm formation, colonization of the inner ETT surface occurred in 14 (70%) cases and 17 isolates were recovered. Five isolates were Gram positive, whereas the majority of isolates were Gram-negative bacilli. Seventeen patients developed pneumonia. All patients who developed biofilm also developed VAP. The occurrence of multidrug resistance among detected microorganisms was high.
Conclusion
We concluded that the density of ETT biofilm increased with increased duration of intubation. We also concluded that ETT colonization with biofilm-producing organisms increased the risk of developing VAP with highly resistant microbes.